Project Summary/Abstract The Institute for Child Health Policy at the University of Florida (UF-ICHP) currently measures and evaluates quality of care for almost 1 in 5 children enrolled in Medicaid and the Children's Health Insurance Program (CHIP) in the US. We collaborate with the Texas Health and Human Services Commission, the Florida Agency for Health Care Administration, the Florida Healthy Kids Program which oversees CHIP, two Texas Medicaid Managed Care Plans and their health system partners, two dental plans, the OneFlorida Clinical Data Research Network, and two External Quality Review Organization (EQRO) partners. These collaborators joined to form the Child Health Quality (CHeQ) Partnership. We also are partnering with PEDSnet, a national network of children's hospitals and providers, who will participate in validation for measure refinements that incorporate electronic health record (EHR) data. Through our collaboration experiences, we identified implementation and dissemination opportunities for the following measure sets: 1) Linkage Between Dental Treatment and Dental Prevention and 2) Safe and Judicious Antipsychotic Use in Children and Adolescents. UF-ICHP has a16-year history in both states in measuring children's quality of care (QOC) and evaluating performance improvement projects. We house fully identified Medicaid and CHIP health care data for all enrolled children from 2007 to the present that are refreshed monthly. Further, we house EHR data in a central repository called the OneFlorida Data Trust for 1.2M or 49% of all children in Florida Medicaid and CHIP, which will be used to enhance the Antipsychotic Use Measure set with metabolic screening and monitoring lab results. We are leveraging our substantial infrastructure and experience to conduct the proposed project and address the required goals as specified in RFA-HS-16-002. The two goals of this project are to test the feasibility and usability of the selected measure sets through: 1) field testing; refining; collecting data, including testing the efficient collection of valuable clinical data from EHRs; and reporting on the measures; and 2) translating the results into QI goals and multi-level performance improvement projects. In addition, we will implement and disseminate leading-edge methods to evaluate and compare quality of care at multiple levels, including the state, health plan, and provider levels. A toolkit, based on lessons learned, that provides practical guidance on how best to design and analyze quality of care data at multiple levels and how to make valid comparisons within and across levels will be developed.